Public Health Commons^™

Editorial: Care During Pregnancy And Early Childhood For Growth And Development In Low- And Middle- Income Countries, Ranadip Chowdhury, Ravi Prakash Upadhyay, Bireshwar Sinha, Nita Bhandari, Sunita Taneja, Jai K. Das

Centre of Excellence in Women and Child Health

No abstract provided.

Cost Estimation Alongside A Multi-Regional, Multi-Country Randomized Trial Of Antenatal Ultrasound In Five Low-And-Middle-Income Countries, B W. Bresnahan, E Vodicka, J B. Babigumira, Ashar Muhammad Malik, F Yego, A Lokangaka, B M. Chitah, Z Bauer, H Chavez, Sarah Saleem

Community Health Sciences

Background: Improving maternal health has been a primary goal of international health agencies for many years, with the aim of reducing maternal and child deaths and improving access to antenatal care (ANC) services, particularly in low-and-middle-income countries (LMICs). Health interventions with these aims have received more attention from a clinical effectiveness perspective than for cost impact and economic efficiency.
Methods: We collected data on resource use and costs as part of a large, multi-country study assessing the use of routine antenatal screening ultrasound (US) with the aim of considering the implications for economic efficiency. We assessed typical antenatal outpatient and …

Multiple-Micronutrient Supplementation In Pregnant Adolescents In Low- And Middle-Income Countries: A Systematic Review And A Meta-Analysis Of Individual Participant Data, Emily C. Keats, Nadia Akseer, Pravheen Thurairajah, Simon Cousens, Zulfiqar Ahmed Bhutta, Global Young Women’S Nutrition Investigators’ Group

Woman and Child Health

Context: Approximately 7.3 million births occur annually among adolescents in low- and middle-income countries. Pregnant adolescents constitute a nutritionally vulnerable group that could benefit from intervention to mitigate the mortality and adverse birth outcomes associated with adolescent pregnancy.
Objective: The aim of this systematic review and meta-analysis was to assess the following: (1) the effect of multiple-micronutrient (MMN) supplementation vs iron and folic acid (IFA) supplementation among adolescents on maternal morbidity, birth outcomes, and mortality outcomes, (2) the effects of MMN supplementation in adolescents compared with the effects in adult women, and (3) the effect modification, if any, of MMN …

“We Have A Lot Of Home Deliveries” A Qualitative Study On The Impact Of Covid-19 On Access To And Utilization Of Reproductive, Maternal, Newborn And Child Health Care Among Refugee Women In Urban Eastleigh, Kenya, Adelaide Lusambili, Michela Martini, Faiza Abdirahman, Abena Asante, Sharon Ochieng, Joseph N. Guni, Rose Maina, Stanley Luchters

Population Health, East Africa

Background: Little is known about how pregnant refugee women, and the frontline health care workers who serve them, are affected by the COVID-19 pandemic in terms of health, and health service access. Women refugees are classified as a vulnerable group with regard to pregnancy outcomes and access to maternal care, and may be disproportionally at risk for COVID-19 infection as they are likely to face unique barriers to information and access to reproductive health services during the pandemic. Few studies identify gaps that could inform potential interventions to improve service uptake for refugee women, particularly in the context of …

A Study Protocol For An Mhealth, Multi-Centre Randomized Control Trial To Promote Use Of Postpartum Contraception Amongst Rural Women In Punjab, Pakistan, Xaher Gul, Waqas Hameed, Sharmeen Hussain, Ishaque Sheikh, Junaid-Ur-Rehman Siddiqui

Community Health Sciences

Background: Provision of family planning services during the immediate post-partum phase is considered effective and cost-efficient for promoting healthy timing and spacing of pregnancies. This research aims to test the effectiveness of mobile phone-based interventions in promoting use of postpartum contraception. Moreover, it will also test the non-inferiority of text and voice messages compared to interactive phone-based counselling.
Methods: A three-arm, 10-month, multicentre, randomized controlled trial will be conducted at 15 social franchise (SF) health facilities in Punjab province of Pakistan. Pregnant women aged 15-44 years who are in their first or second trimester and have a mobile phone for …

Quality Of Antenatal Care And Its Relationship With Women’S Intended Use Of Their Anc Facility For Delivery: A National Cross-Sectional Study In Kenya, Jisoo Kim

Electronic Thesis and Dissertation Repository

Maternal deaths have been one of the leading causes of deaths in sub-Saharan Africa. Delivering at an institution can prevent the majority of maternal deaths in developing countries. A national cross-sectional survey of Kenya was used to determine if the quality of antenatal care (ANC) provided to women is associated with their intention to deliver at the same facility. Multilevel mixed-effects logistic regression was used to examine this relationship. Quality of ANC variables assessed in this study were not significantly associated with women’s intention to deliver at the same facility. Mothers preferred to deliver at hospitals, rather than clinics/dispensaries. ANC …

Factors Associated With Iron-Folic Acid Supplement Use Among Pregnant Women In Karu, Nasarawa State, Nigeria - A Cross Sectional Study Using Theory Of Planned Behavior, Toyin O. Akomolafe

Electronic Theses and Dissertations

Introduction: Iron-folic acid supplementation is one of the key interventions provided during antenatal care (ANC) services to reduce iron deficiency, maternal anemia, low birthweight and other pregnancy-related complications responsible for maternal and neonatal mortality. However, use of iron-folic acid supplements and adherence with recommended dosage in Nigeria is low. The purpose of this cross-sectional study was to examine factors associated with iron-folic acid supplements use among pregnant women in Karu local government area (LGA), Nasarawa, Nigeria. Methods: Questionnaires were administered in face-to-face interviews with 64 pregnant women (18 – 49 years old) and 19 healthcare providers in selected …

Individual And Structural Environmental Influences On Utilization Of Iron And Folic Acid Supplementation Among Pregnant Women In Harare, Zimbabwe, Chiwoneso B. Tinago, Lucy Annang Ingram, Christine E. Blake, Edward A. Frongillo

Public Health Sciences Faculty Publications

Micronutrient deficiencies are prevalent among Zimbabweans with serious health and social implications. Due to a lack of a national micronutrient food fortification policy, the Zimbabwe Ministry of Health and Child Care established a policy for the prevention of maternal micronutrient deficiencies, which centres on pregnant women receiving daily iron and folic acid (IFA) at their first antenatal care visit and throughout pregnancy. Despite these efforts, utilization of IFA supplementation in pregnancy in Zimbabwe is low. This study aimed to understand the experiences and knowledge of IFA supplementation among pregnant women and healthcare workers in Harare, Zimbabwe, and the influence of …

Implementation Of Evidence-Based Antenatal Care In Mozambique: A Cluster Randomized Controlled Trial: Study Protocol, Leonardo Chavane, Mario Merialdi, Ana Pilar Betrán, Jennifer Requejo-Harris, Eduardo Bergel, Alicia Aleman, Mercedes Colomar, Maria Luisa Cafferata, Alicia Carbonell, Marleen Temmerman

Obstetrics and Gynaecology, East Africa

Background: Antenatal care (ANC) reduces maternal and perinatal morbidity and mortality directly through the detection and treatment of pregnancy-related illnesses, and indirectly through the detection of women at increased risk of delivery complications. The potential benefits of quality antenatal care services are most significant in low-resource countries where morbidity and mortality levels among women of reproductive age and neonates are higher. WHO developed an ANC model that recommended the delivery of services scientifically proven to improve maternal, perinatal and neonatal outcomes. The aim of this study is to determine the effect of an intervention designed to increase the use of …

Risk Factors Associated With Birth Asphyxia In Rural District Matiari, Pakistan: A Case Control Study, Farhana Tabassum, Arjumand Rizvi, Shabina Ariff, Sajid Bashir Soofi, Zulfiqar Ahmed Bhutta

Department of Paediatrics and Child Health

Background: During the past two decades there has been a sustained decline in child mortality; however, neonatal mortality has remained stagnant. Each year approximately 4 million babies are born asphyxiated resulting in 2 million neonatal deaths and intrapartum stillbirths. Almost all neonatal deaths occur in developing countries, where the majority is delivered at homes with negligible antenatal care and poor perinatal services.
Objectives: To identify socio-demographic and clinical risk factors associated with birth asphyxia in Matiari District of Sindh Province, Pakistan.
Method: A matched case control study was conducted in Matiari District with 246 cases and 492 controls. Newborn deaths …

Coverage And Quality Of Antenatal Care Provided At Primary Health Care Facilities In The ‘Punjab’ Province Of ‘Pakistan’, Muhammad Ashraf Majrooh, Seema Hasnain, Javaid Akram, Arif Siddiqui,, Zahid Memon

Centre of Excellence in Women and Child Health

Background: Antenatal care is a very important component of maternal health services. It provides the opportunity to learn about risks associated with pregnancy and guides to plan the place of deliveries thereby preventing maternal and infant morbidity and mortality. In ‘Pakistan’ antenatal services to rural population are being provided through a network of primary health care facilities designated as 'Basic Health Units and Rural Health Centers. Pakistan is a developing country, consisting of four provinces and federally administered areas. Each province is administratively subdivided in to ‘Divisions’ and ‘Districts’. By population ‘Punjab’ is the largest province of Pakistan having …

Antenatal Care Determines Immunization And Care For Fever And Diarrhea In Ghanaian Children, Natalie K. Mcglynn

Electronic Thesis and Dissertation Repository

Enhancing maternal and child health comprise key Millennium Development Goals (MDGs), driving an analysis of whether efforts to improve maternal health through quality antenatal care (ANC) is associated with the recommended health-related care of children in Sub-Saharan Africa, where under-five mortality is the highest.

This study examines ANC as a potential determinant of immunization and appropriate care for fever and diarrhea in Ghanaian children. Data were pooled from the 1998, 2003, and 2008 Ghana Demographic Health Surveys, and Andersen’s Behavioural Model provided the conceptual framework.

Multivariate logistic regression indicated that quality ANC increases the odds of immunization and appropriate care …

Are Marginalized Women Being Left Behind? A Population-Based Study Of Institutional Deliveries In Karnataka, India, Paul C. Adamson, Karl Krupp, Bhavana Niranjankumar, Alexandra H. Freeman, Mudassir Khan, Purniman Madhivanan

HWCOM Faculty Publications

Background

While India has made significant progress in reducing maternal mortality, attaining further declines will require increased skilled birth attendance and institutional delivery among marginalized and difficult to reach populations.

Methods

A population-based survey was carried out among 16 randomly selected rural villages in rural Mysore District in Karnataka, India between August and September 2008. All households in selected villages were enumerated and women with children 6 years of age or younger underwent an interviewer-administered questionnaire on antenatal care and institutional delivery.

Results

Institutional deliveries in rural areas of Mysore District increased from 51% to 70% between 2002 and 2008. …

Pengaruh Pemeriksaan Kehamilan Terhadap Pemilihan Penolong Persalinan, Besral Besral

Kesmas

Di Indonesia, Angka pertolongan persalinan oleh tenaga kesehatan masih tergolong rendah. Pemeriksaan kehamilan (Antenatal Care = ANC) dapat dijadikan sebagai sarana untuk memotivasi ibu hamil agar bersalin ke tenaga kesehatan. Penelitian ini bertujuan mengetahui peranan ANC terhadap pemilihan tenaga penolong persalinan. Penelitian dengan rancangan potong lintang ini menggunakan data sekunder Survei Evaluasi Manfaat Proyek KKG (Kesehatan Keluarga dan Gizi), analisisnya menggunakan ukuran asosiasi Odds Ratio. Hasil penelitian ini memperlihatkan bahwa setelah dikontrol oleh variabel karakteristik responden, ibu hamil yang melakukan ANC minimal empat kali memiliki peluang 2 kali lebih besar untuk melahirkan pada tenaga kesehatan daripada ibu hamil dengan ANC …